Week in Washington 12162021

Week in Washington is brought to you by Michael Cohen, PhD. Tune in each week to read the latest on healthcare policy and get a glimpse of what’s on the horizon.

Week in Washington



  • Congress passed a slew of bills in anticipation of the coming recess including a debt ceiling change, Defense authorization and change to Medicare sequestration.  

  • The Sequestration bill did the following

    • Delayed cuts due to PAYGO until 2023

    • Reduced Sequestration for Medicare

      • Jan 1 to March 31- 0%

      • April 1- June 30- 1%

      • June 30 to Dec 31 – 2%

    • The conversion factor for the 2022 Medicare physician fee schedule will be an increase of 3% (this is a decrease of last year’s 3.75% increase).

    • Delayed other Medicare cuts (e.g., Medicare radiation oncology model)

  • It was also announced that the Build Back Better bill would not be passed this year and more likely pushed back at least until March. Congress will continue to work on BBB so potential changes could be announced next week (although no vote will happen).

HHS Regulation

The White House also announced its intended slate of forthcoming regulations. You can see it here. The regulations affect Medicare, Medicaid, and ACA markets. Notable flags include short-term duration plan changes, changes to core Medicaid plan reporting requirements, and alternative payment models. Additionally, Politico reported that CMS is looking at additional regulations for Prescription Benefit Managers (PBMs).


  • Numbers- COVID cases and hospitalization rose slightly this past week. Parts of the Midwest (Minnesota, Michigan, and Ohio) are seeing some of the highest rates of COVID related hospitalizations yet experienced.

  • Omicron- The expectation is that cases will increase as the Omicron variant becomes more prevalent. For example, South Africa and the UK are currently experiencing case numbers in excess of prior waves. The exact impact on hospitalizations and death is uncertain, although areas where take-up of boosters is lower are likely to see larger surges.

New and Notes

NHE/KFF- Updated National Health Expenditure Data was released this week. KFF has a good summary here. Overall, US spending increased 9.7%, driven by increased federal spending growth. Out of pocket spending actually decreased, due to lower utilization. Public spending increased 113%. Prescription drug spending increased 35%.  You can read about OACT’s analysis here.

Previous editions: 

12/09/2021: Week in Washington

12/02/2021: Week in Washington

11/18/2021: Week in Washington

11/11/2021: Week in Washington



11/04/2021: Week in Washington

10/28/2021: Week in Washington

10/21/2021: Week in Washington

10/14/2021: Week in Washington


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